This work offers insights into the vascular derangements occurring in sepsis and has implications for other infectious disease processes (e.g., disseminated herpes simplex virus or dengue viral infection) and for noninfectious processes (e.g., ischemia/reperfusion injury, atherosclerosis, cancer dissemination) where heparanase may have a prominent role in pathogenesis (42, 53–57). This evidence concerns the gene HPSE and atherosclerosis.